在一次,两次或三次抗血栓治疗的心房患者中主要出血率
Nienke van Rein1,2,3, Uffe Heide-Jørgensen3, Willem M Lijfering1,2,4
1Department of Thrombosis and Hemostasis, Leiden University Medical Center, The Netherlands (N.v.R., W.M.L.).
Circulation
|December 28, 2018
概括
对心房的三重治疗显著增加了严重出血的风险,特别是在老年患者或具有高CHA2DS2- VASc分数的患者中. 在这些高危人群中,需要仔细考虑三重抗血栓治疗.
科学领域:
- 心脏病学
- 药理学
- 公共卫生
背景情况:
- 对于心房的治疗,通常需要使用抗凝剂和抗血小板剂.
- 在高风险的AF患者中,对结合抗血栓治疗的出血风险的数据有限.
研究的目的:
- 在不同抗血栓治疗策略中评估老年AF患者 (≥50岁) 的重大出血率.
- 为了比较单疗法,双疗法和三疗法相关的出血风险.
主要方法:
- 使用处方数据对丹麦AF患者进行全国性队列研究.
- 估计了严重出血的发病率 (IR) 和危险比率 (HR).
- 根据治疗方式,年龄,CHA2DS2-VASc得分和并发症分层分析.
主要成果:
- 与单一治疗或双重治疗相比,三重治疗显示出明显更高的严重出血率.
- 年龄大于90岁或CHA2DS2- VASc分数大于6的三重治疗患者出血率非常高 (17. 6 - 22. 8/100 PYs).
- 与VKA单一治疗相比,用维生素K抗剂进行的三重治疗显示HR为3. 73,直接口服抗凝剂的三重治疗显示HR为2.28.
结论:
- 在AF患者中,三重抗血栓治疗与严重出血风险的显著增加有关.
- 在老年患者 (> 90岁) 中,高CHA2DS2- VASc分数 (> 6) 或先前出血病例的患者中,需要谨慎使用三重疗法.
相关概念视频
Amyloid Fibrils
11.9K
Amyloid fibrils are aggregates of misfolded proteins. Under most circumstances, misfolded proteins are either refolded by chaperone proteins or degraded by the proteasome. However, in the case of a mutation or a disease, these proteins can accumulate to form large clusters and often further assemble to form elongated fibers, called fibrils.
Amyloid deposits were observed as early as 1639 in the liver and the spleen. In 1854, Rudolph Virchow performed iodine staining,...
Amyloid deposits were observed as early as 1639 in the liver and the spleen. In 1854, Rudolph Virchow performed iodine staining,...
11.9K
Amyloid Fibrils
6.4K
6.4K
Bleeding in Fresh Concrete
576
Bleeding in fresh concrete occurs when water from the mix rises to the surface. This happens because the mix's solid components fail to retain all the water as they settle, leading to separation where water collects at the top. The severity of bleeding can be measured by assessing the total settlement or by noting the decrease in height per unit height of concrete.
Bleeding can cause several issues in the concrete structure. Sometimes, the rising water gets trapped beneath large aggregate...
Bleeding can cause several issues in the concrete structure. Sometimes, the rising water gets trapped beneath large aggregate...
576
Fibril-associated Collagen
3.4K
Fibril-associated collagens are a type of collagens present in the extracellular matrix with interrupted triple helices or FACIT (Fibril-associated collagens interrupted triple-helices). FACIT help connect and attach the collagen fibrils with each other as well as with other proteins of the extracellular matrix.
For example, the type II collagen fibrils in cartilage have covalently bound type IX fibril-associated collagens at regular intervals. Other types of fibril-associated collagens are...
For example, the type II collagen fibrils in cartilage have covalently bound type IX fibril-associated collagens at regular intervals. Other types of fibril-associated collagens are...
3.4K
Major Organs of the Digestive System
9.5K
The digestive system is responsible for the ingestion of food, secretion of enzymes, mixing and digesting food, absorption of the nutrients and defecation. The human digestive system consists of two major parts: the gastrointestinal tract and the accessory digestive organs.
Gastrointestinal tract:
Gastrointestinal tract:
9.5K
Major Hormones and Their Functions
1.9K
Hormones, the biochemical messengers produced by endocrine glands, are pivotal in regulating bodily functions and maintaining homeostasis. Each hormone's balance is crucial; imbalances can lead to significant physiological disruptions. Major hormones include oxytocin, cortisol, epinephrine, estrogen, testosterone, thyroxine, growth hormone, insulin, and glucagon.
Oxytocin, produced in the hypothalamus and released by the pituitary gland, plays a role in social bonding, childbirth, and...
Oxytocin, produced in the hypothalamus and released by the pituitary gland, plays a role in social bonding, childbirth, and...
1.9K


